Laserfiche WebLink
APPLICATIQI`��FOR CONSTRUCTI"."N PERMIT <br /> CITY OF EVERETT•BUILDING DIVISION � <br /> 3200 CEDAR STREET•EVERETT,WA 98201 •259-8810 <br /> ❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL �pLUMBING ❑ SIGN <br /> PROJECTADDRESS:�Z�z l�N'JA� U )c�a. - f�� ,� (,-/ <br /> S-�rx.v� �� r+t 3�(OI —r,cDa.Q.� S ��� 9b'zrJ/ �l� /U� 7 <br /> OYRIER 7 M �I��p(�/�55 CITY SIP PIIpNC <br /> �/ ���/�/%/� )�d�'��1� � <br /> iE1Y1NT , YWLMOf1[55 CITY tIP PIIONE <br /> �RCMTECTORDESIGNER MMI�DDqE55 dTY 71P PNpNE <br /> GE6EOq pONf�� MN� 5 pTY I�p PIIONE SI�tE IICENSp� <br /> , MORES <br /> I�.l 77 YV%S <br /> MECH�VlICµCONTR�CTOR MMt�Dp1E55 f.ltt IIP PIION[ <br /> ST�LE ItCEN$E r <br /> PWMBINGCpITR�CTOfI MIJIApppE55 qtt ZIP PNONE <br /> �1� STATE L10EN5E• <br /> CANTMCT PqI�E pF Wpql( <br /> HEATING SVSTEM: ❑GAS ❑ ELECTRIC ❑ <br /> �ESCMME WiXiK ANO$qJ�RE FppTAGE MVOlVEO Cq1tALT P[RSONAN�PHpNE ryp <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> ruovos¢u use ov eu�d.xi APPLICATION AND KNOW 7HE SAME TO BE TRUE AND CORRECT ALL <br /> PROVISIONS OF UWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> �����PT���EpTYI�p�lEIOWORARACHTWp[pqES) WORK WILI BE COMPUED WITH WHETHER SPECIFIED MEREIN OH <br /> NOT. THE 6RANT1N6 Of A PEpMIT DOES NOT PRESUME TO GIVE <br /> ��T B�� o� AUTHORI7Y TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STA7E OR LOCAL LAW REGUUTINO CANSTRUCTION OR THE <br /> PERFORMqNCE OF CONSTRUCTION.THAT I AM AUTHOAIZED BY THE <br /> OWNER OF THIS PROPERTV TO pERFORM THE WORK FOR WHICH <br /> APPIICATION IS MI1DE AND I COMPLY WITH THE STATE <br /> 7MCELTM I D.NUTABEq CON7H/AClTORS LAW 1827 qCW AND 296200 WAC. <br /> COM57�N1CiqN IO�N LENOER.11DpHE55.TEIEAIONE NUMEF.q ` ��',p�i-'l2l�r D 9- �7- 9l0 <br /> N�ru� o•te <br /> CITY BVSiNE55 t10EN5E NO <br /> PLUMMNO MECMANICAL <br /> MU• TYPE OF FlIfTURE OR ITEM FEE NO. T11VE pF Ep��pMENT �p <br /> WATER CLOSET(TOILET) � NC—AMNDLQ UNfTS � <br /> BATHTUB ; FORCEO AIR SYSTEMS � <br /> Z. LAVATORY(WASH BASIN) � HEO:!PUMP � <br /> SHOWER � UNI7'HEATERS � <br /> KITCHEN SINK 6 DISP i CLOTHES DRVERS � <br /> � <br /> DISHWASHEH � RANGE HOOD , <br /> LAVNDRY TRAV � WATER HEATER � <br /> CLOTHES WASHER ' <br /> � WOODSTOVE , <br /> URINAL � MEfAI FIREPLACE(WOOD BURNING) � <br /> DRINKING FUUNTAIN ; FIREPIACE INSERT�WOOD BURNING) � <br /> FLOOR DRAIN � GAS FIREPUICE � <br /> BACKFIOW PREVENTERS ' GASRANGE � <br /> � <br /> i <br /> SINK(SERVICE—BAR,ETC.) � GAS PIPING , <br /> ' Z_ EXHAUSTFAN <br /> � <br /> � <br /> i � <br /> _ SUB TOTAL f ; SUB TOTAL f ; <br /> PERMIT S /� i PERMIT S i <br /> TOTALFEE f � TOTALFEE f <br /> FOR OFFICE U5E ONLY: <br /> �AONT SETPACK RE�R SETP�ICI( SIDE SETB�LN PUN CIIEGR NUMeCfi fEF RECEIPf NO <br /> �2�499 <br /> usE zowE l07�RE� V�C�N�SI1E FEES VALUATION FEE <br /> ❑YES ❑NO BUILDINC � <br /> � <br /> NEIGHi LIMI7ATIpN NO OF DWELLIN(3 512E OF BLDGRI � <br /> UH11C i— <br /> rwueivc � 2� <br /> ��' I <br /> GC�CU'PANCY Iq pf510PoES OCCUPANfL0�0 B�SEMENT MECNnNIC�I � <br /> V <br /> ❑YES ❑NO ���! <br /> FIflESPRINKLERREO'D REASON AUD17104�I R�NCIICLK � <br /> ��-- <br /> 0�11Ef1 � <br /> i <br /> FlqE\WiMRC-0'0 RE�Spry ! <br /> � <br /> SI�IE OWlDR�O SIIfiC1U0f.E <br /> TrrEovr,oNsr rinHs�rrnovEoer CITYOFEVERETT rueucwonKs <br /> LOCAI SALES ' <br /> OAIE TAX CODE IS 3105 TOTAL �� <br />